This leaflet is provided by the Royal College of Psychiatrists, the professional body responsible for education, training, setting and raising standards in psychiatry. They also provide readable, user-friendly and evidence-based information on various mental health problems.
What is an eating disorder?
Worries about weight, shape and eating are common, especially among young girls. A lot of young people, many of whom are not overweight in the first place, want to be thinner. They often try to lose weight by dieting or skipping meals. For some, worries about weight become an obsession. This can turn into a serious eating disorder.
This leaflet is about the most common eating disorders, anorexia nervosa and bulimia nervosa.
- Someone with anorexia nervosa worries all the time about being fat, even if they are skinny, and eats very little. They lose a lot of weight, and in girls their periods become irregular or stop.
- Someone with bulimia nervosa also worries a lot about weight. They alternate between eating next to nothing, and then having binges when they gorge themselves. They vomit or take laxatives to control their weight.
Both of these eating disorders are more common in girls, but do occur in boys. They can happen in young people of all backgrounds and cultures.
What are the signs of anorexia or bulimia?
You may notice some or most of these signs:
- Weight loss or unusual weight changes.
- Periods being irregular or stopping.
- Missing meals, eating very little and avoiding 'fattening' foods.
- Avoiding eating in public, secret eating.
- Large amounts of food disappearing from the cupboards.
- The person believing they are fat when in fact they are underweight.
- Exercising excessively, often in secret.
- Becoming preoccupied with food, cooking for other people, calorie counting and setting target weights.
- Going to the bathroom or toilet immediately after meals.
- Using laxatives and vomiting to control weight or sometimes using other medications/herbal remedies to lose weight.
It may be difficult for parents or teachers to tell the difference between ordinary dieting in young people and a more serious problem. If you are concerned about your child's weight and how they are eating, consult your GP. You can also seek help and advice from other agencies.
What effects can eating disorders have?
A person with an eating disorder can have physical and emotional problems. Some of these include:
- Feeling excessively cold.
- Headaches and dizziness.
- Changes in hair and skin.
- Tiredness and difficulty with normal activities.
- Damage to health, including stunting of growth and damage to bones and internal organs.
- Loss of periods and risk of infertility.
- Anxiety and depression.
- Poor concentration, missing school, college or work.
- Lack of confidence, withdrawal from friends.
- Dependency or over-involvement with parents, instead of developing independence.
It is important to remember that, if allowed to continue unchecked, both anorexia and bulimia can be life-threatening conditions. Over time, they are harder to treat, and the effects become more serious.
What causes eating disorders?
Eating disorders are caused by a number of different things:
- Worry or stress may lead to comfort eating. This may cause worries about getting fat.
- Dieting and missing meals lead to craving for food, loss of control and overeating.
- Anorexia or bulimia can develop as a complication of more extreme dieting, perhaps triggered by an upsetting event, such as family breakdown, death or separation in the family, bullying at school or abuse.
- Sometimes, anorexia and bulimia may be a way of trying to feel in control if life feels stressful.
- More ordinary events such as the loss of a friend, a teasing remark or school exams may also be the trigger in a vulnerable person.
Who can develop an eating disorder?
Some of the factors which increase the likelihood of having an eating disorder include:
- Being female.
- Being previously overweight.
- Lacking self-esteem.
- Being a perfectionist.
Young people with eating disorders often show obsessional behaviour.
Some people are more at risk than others. Sensitive or anxious individuals, who are having difficulty becoming independent from their families, are also more at risk. Eating disorders can also run in families. The families of young people with eating disorders often find change or conflict particularly difficult, and may be unusually close or overprotective.
Where can I get help?
If you think a young person may be developing an eating disorder, don't be afraid to ask them whether they are worried about themselves. Quite often young people with eating disorders are unable to acknowledge that there may be a problem, will not want you to interfere and may become angry or upset when you do. However, you may still be worried and you can seek advice from professionals in different agencies such as your GP or a paediatrician. It is important that you feel supported and not alone.
What can I do to help?
These simple suggestions are useful to help young people to maintain a healthy weight and avoid eating disorders:
- Ensure your child eats regular meals. The British Dietetic Association (www.bda.uk.com) recommends eating regularly throughout the day, which usually means three main meals and three nutritious snacks in between, such as fruit, yogurt or nuts. Too many sugary or high-fat snacks should be avoided.
- Try to give a 'balanced' diet, one that contains all the types of food your body needs, including carbohydrate foods such as bread, rice, pasta or cereals with every meal.
- Don't let them miss meals - long gaps encourage overeating.
- Encourage regular exercise.
- Educate your child not to be influenced by other people skipping meals or commenting on weight.
When is professional help needed?
When eating problems make family meals stressful, it is important to seek professional advice. Your GP will be able to advise you about what specialist help is available locally and arrange a referral. Help may be available through the paediatrician, dietitian or your local child and adolescent mental health service (CAMHS).
If the eating disorder causes physical ill health, it is essential to get medical help quickly. If untreated, there is a risk of infertility, thin bones (osteoporosis), stunted growth and even death, but if treated, most young people get better.
Content used with permission from the Royal College of Psychiatrists website: Eating disorders in young people (March 2012, due for review March 2014). Copyright for this leaflet is with the Royal College of Psychiatrists.